AFPPGMC Form
Application for Claim of Unpaid Monthly Pension/Payment of Cancelled Checks
(Authority: Para 3c & 3d, Personnel Dir Nr 01-05 dtd 02 Jun 05)
Date: 01/19/2023
The Chief
AFP Pension and Gratuity Management Center
Camp General Emilio Aguinaldo
Quezon City 1110
Sir,
I, __________________________________________________, _________,
(Full Name of Applicant)(Age)
_____________, of _____________________________________________________
(Date of Birth)(Present Permanent Address) (to be accomplished if applicant is a beneficiary pensioner)
the ____________ of ___________________________________________________
(Relation) |
(Name of Principal Pensioner) |
is applying for claim of unpaid monthly pension / replacement of cancelled pension checks pursuant to Section 17 & 18 PD 1638/RA 340. Details of claim are as follows (state period of claim and reason for not receiving pension or for checks becoming stale. If more space is required, attached explanation/reasons)
Herewith are the pertinent documents relative to my application for unpaid monthly pension / payment of cancelled checks.
(____) Pensioner Update Form
I declare, under the penalties of perjury pursuant to the provisions of existing laws that the information stated above are true and correct. Further I certify that the documents attached herewith provide authentic information to support my request/claim.
_______________________________
(Signature over printed name)
Note: Requirements for Principal
1.Pensioner Update Form (PUF)
2.Retirement Order
3.Marriage Contract
4.Pensioner ID
5.Pension Account ( LBP/UCPB OR PVB) For Widow:
1.Pensioners Update Form (PUF)
2.Retirement or Posth Order
3.Declaration of Legal Beneficiaries
4.Death Certificate (NSO)
5.Pensioner ID
6.Marriage Contract (NSO)
7.Pension Account ( LBP/UCPB OR PVB)
8.NSO CRS form #5 (Advisory on Marriages)